Changes in muscle strength and physical function in older patients during and after hospitalisation : A prospective repeated-measures cohort study

Journal article


Hartley, Peter, Romero-Ortuno, Roman, Wellwood, Ian and Deaton, Christi. (2021). Changes in muscle strength and physical function in older patients during and after hospitalisation : A prospective repeated-measures cohort study. Age and Ageing. 50(1), pp. 153-160. https://doi.org/10.1093/ageing/afaa103
AuthorsHartley, Peter, Romero-Ortuno, Roman, Wellwood, Ian and Deaton, Christi
Abstract

Aim
to investigate changes in knee-extension strength and physical function in older adults during and after acute hospital admission, and the contributions of illness severity, frailty and sedentary activity to changes in knee-extension strength.

Methods
prospective repeated-measures cohort study on a sample of participants aged ≥75 recruited within 24 hours of acute hospital admission. Knee-extension, grip strength and functional mobility (de Morton Mobility Index, DEMMI) were measured at recruitment, day 7 (or discharge if earlier), and at follow-up 4–6 weeks later. During the first 7 days, continuous measurement of physical activity and daily measurements of muscle strength were taken. Participants recalled the functional ability they had 2-weeks before admission and self-reported it at follow-up (Barthel Index, BI).

Results
sixty-five of 70 participants (median age 84 years) had at least one repeated measure of muscle strength in hospital. Knee-extension strength declined during hospitalisation by 11% (P < 0.001), but did not change post-hospitalisation (P = 0.458). Grip strength did not change during hospitalisation (P = 0.665) or from discharge to follow-up (P = 0.508). General functional ability (BI) deteriorated between 2 weeks before admission and follow-up (P < 0.001). Functional mobility (DEMMI) improved during hospitalisation (P < 0.001), but did not change post-hospitalisation (P = 0.508). A repeated-measures mixed model showed that greater loss in knee-extension strength during hospitalisation was associated with increased sedentary time, frailty and baseline strength and lower baseline inflammatory levels.

Conclusions
our observations add to a growing body of evidence on potential risk factors for hospital-associated deconditioning.

Keywordshospital; deconditioning; activity; frailty; strength; older people
Year2021
JournalAge and Ageing
Journal citation50 (1), pp. 153-160
PublisherOxford University Press
ISSN0002-0729
Digital Object Identifier (DOI)https://doi.org/10.1093/ageing/afaa103
Scopus EID2-s2.0-85099721859
Page range153-160
FunderDunhill Medical Trust
Addenbrooke’s Charitable Trust
Science Foundation Ireland
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online09 Sep 2020
Publication process dates
Deposited02 Dec 2022
Grant IDRTF115/0117
32/17 A (ii)
18/FRL/6188
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